Individual
BRADLEY JEROME WINTERHALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 DIVISION ST E, BUFFALO, MN 55313-1522
(763) 682-1911
(763) 682-6005
Mailing address
561 BRADSHAW AVE NE, BUFFALO, MN 55313-4302
(763) 682-1911
(763) 682-6005
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
115940-0
MN
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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